The Gordon Wilson Lecture. Growth hormone replacement in adults and other uses.

The modern era of growth hormone research began in 1981 with the characterization and synthesis of the primary stimulator of GH synthesis and secretion, growth hormone releasing hormone. Discovery of this peptide and studies in human adults and children resulted in unraveling the complex nature of the regulation of GH secretion. Discovery of regulatory mechanisms has permitted a greater understanding of normal and abnormal growth hormone physiology. The use of growth hormone therapeutically as replacement in GH deficient adults is in its medical infancy, but preliminary studies indicate a beneficial effect on body composition, serum lipid concentrations, bone mineral density, muscle strength, and exercise endurance. These studies over the past decade resulted in Food and Drug Administration approval of GH for replacement in adults with hypothalamic or pituitary disease. It remains to be determined whether or not chronic GH replacement will have beneficial effects on morbidity and mortality. The use of growth hormone in other areas such as aging, catabolic illness, obesity, diabetes, and muscular disorders is under active investigation and risks and benefits remain to be determined.